26-year-old Egyptian Male Patient Case Study Assignment Help

Major sim ONE - Pre brief

Remember, your second assessment item is a critical reflection on a major simulation event. You have two major simulations during the residential school. This is the first major simulation. It is highly recommended to take some reflective notes on your experience which will support the completion of the reflection. For example;

• Overview of the simulation
• Your experience and practice as an individual and as a team member
• The impact of your communication with colleagues and patient
• Areas that you could improve

The critical reflection is due two weeks after the residential school.

Pre brief

CASE STUDY AND ALL THE INFORMATION FOR THIS TASK THAT NEED TO BE DONE.

T.J., a 26-year-old Egyptian male, presents to the emergency department with a chief complaint of abdominal pain. His symptoms began two days earlier, with abdominal pain that is mostly diffuse but seems to be more intense in the right lower quadrant. He rates the pain as an 8 on a scale of 1 to 10. He also has had associated anorexia, nausea, vomiting, diarrhoea, fatigue, weakness, and shortness of breath. The diarrhoea is described as watery, non- bloody, and occurring approximately 10 times per day, without bowel incontinence and hematochezia. He describes the nausea as occasional, with two episodes of vomiting that day. The patient has never had this type of pain or combination of symptoms before. He denies taking any medications in the past month, but does admit to a Sulphur drug allergy. The patient's past medical history included incision and drainage of a perianal abscess when he was 18 years old. The family history is significant for hypertension. T.K.is a Christian minister who lives with his pregnant wife and their two-year-old daughter. He has a five pack-year smoking history, with smoking abstinence for the past five years. He denies alcohol or illicit drug use, or any recent travel history or contact with individuals with similar gastrointestinal symptoms. He is 180cm tall and weighs 58kg. TJ was referred to the gastroenterologist for further investigation and diagnosis. A series of blood tests, stools test, imaging and an endoscopy and colonoscopy with a tissue biopsy was performed. A diagnosis of Crohns has been made and TJ has been educated on the disease. The surgeon has advised immediate surgery to remove part of TJ’s large intestines and to perform a large bowel resection and formation of colostomy to ‘rest ‘the bowel. In view of reversing the procedure in 6 weeks’ time.

TJ has consented to the procedure as the symptoms have been very difficult to live with and has impacted on his ability to work. He is anxious but has signed the consent form. He has been seen by the colorectal clinical nurse consultant, the anaesthetist and the dietician. He has commenced ‘glycoprep’ and is to be NBM. In this session, you will work in small groups (3-4) to provide appropriate nursing care (assessment, interventions, evaluation, documentation, etc.) for a complex case scenario. At the conclusion of the simulation you will need to provide a handover to the night shift.

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Handover

Hi. Are you the nurse taking over care for Mr Joshua, I’m Naomi, the RN from theatres and I have been looking after TJ in recovery. TJ has had a large bowel resection and formation of colostomy. TJ is a 26 year old man, who has been experiencing nausea, vomiting, diarrhoea, fatigue, weakness, and shortness of breath. He was diagnosed with Crohns disease. He is allergic to sulpher. Has a family history of hypertension and a perianal abscess drained about 8 years ago. Currently his BP is 105/50, HR 98, RR 14, Spo2 95% 4L HM, temp 35.9.He has one peripheral IVC in his left arm and a PICC line in his R cubital fossa. He also has a R subclavian CVC. He is currently receiving Hartman’s at 125mls/hr and has an order to commence TPN this evening. He has a stoma bag in situ, the stoma is pink. Nil drainage. He has an IDC in situ draining well. NG tube to remain NBM. He has had 2.5mg of morphine IV about 10 mins ago and is written up for a PCA. And that’s about it, he has antib’s ordered that need to commence tonight.

As you assist transferring the patient from the theatre trolley to the bed the NG tube falls out.

Oh sorry about that, you will need to insert another one. Have a good shift!

What is glycoprep and why is it used in this case?

2. Identify and describe the psychosocial impact of having a colostomy.
3. Who are the multidisciplinary team members we could call upon to support TJ?

 Conducting a primary survey

Collecting, documenting and/or responding to vital observations

Collecting and interpreting subjective data through nursing/health interviews

Collecting and interpreting objective data by applying evidencebased approaches to conduct a focused physical assessment

Nursing Interventions

CVAD dressings using sterile technique

Blood administration

Administering pain relief

Insertion of NGT

Removal of surgical drains

Care of complex wounds and stoma care

Insertion of IDC and urinalysi

In this reflection you should:

• Provide an overview of the major simulation event (approx. 200 words).
• Discuss your experience and your practice as an individual and also as a member of a team (approx. 400 words).
• Discuss the application of mindful communication with the patient and your colleagues in the scenario. You should consider how the quality of communication could have impacted the outcome of the scenario (approx. 300 words).
• Identify areas for improvement and growth (approx. 300 words).

NOTE CHECK THE MARKING CRIERIA WHERE THEY WILL BE LOOKING FOR TO GET THE MARKS. PLEASE SUPPORT THE INTEXT REFRENCE THAT NEED TO BE. BELOW IS THE MAKINF CRITERIA.

You have analysed the reason why you have chosen this goal and made strong connections to your experience and decisions in Major Simulation One (1). Limitations of your experience have been considered.

(18 - 20 marks)

integrity, and is error free for the APA 7^th ed. style conventions.

(8.1 - 10 marks)

Presentation

Scholarly papers, reports, or other similar assessment items must be ‘word processed’ and not handwritten. Requirements include:

• Leave 2 cm margins and double line space your work;
• Use 12pt font, unless otherwise indicated;
• Number all pages;
• Insert student name and number in header or footer of every page of every assignment; and

Include a title page that includes the subject name and code, title of the assessment task, due date, lecturer’s name, student’s name and student’s number